BCG: should you give your baby the tuberculosis vaccine?

The vaccine against tuberculosis, known as BCG, is no longer compulsory for newborns in France since 2007. However, it may be relevant to have our child vaccinated if we are going to stay in a country where tuberculosis is still circulating or if a someone around us has been affected, for example.

Tuberculosis: why the BCG vaccine is no longer mandatory

Tuber vaccination is always included in the immunization schedule, but no longer compulsory for children since 2007. Before that date, all children entering a community (nursery or school) had to be vaccinated against this disease.

But the low incidence of tuberculosis in France, with 8 cases per 100 inhabitants (the threshold usually considered for vaccination being 10/100 000), encouraged the competent authorities to make this vaccination optional. The incidence of tuberculosis is still steadily decreasing today, although exceptions persist, especially in families from areas of the world where the bacteria circulate a lot, or in certain regions, including the‘Ile-de-France. Globally, more than 2 billion people are still affected by the disease and 1,8 million die from it each year.

As Professor Daniel Floret, chairman of the Technical Committee on Vaccinations, also points out, other reasons explain the decision to no longer make BCG compulsory, such as ” its efficiency which is not optimum and its significant side effects. The risk of abscess or even a pressure sore at the injection site, but also the possible appearance of lymph nodes, sometimes large, are elements to be taken into account. Even so, in children at high risk of tuberculosis, it is estimated that the benefit / risk ratio is in favor of vaccination. BCG remains the only vaccine that protects babies against tuberculosis.

Meaning: what name is behind the acronym BCG?

The vaccine is named after the researchers who discovered Koch’s bacillus: Calmette and Guérin – the bacillus being the bacterium which infects the lungs and causes tuberculosis.

BCG: why do the vaccine against tuberculosis?

Now more targeted, the use of BCG remains strongly recommended for all children at risk. Today, vaccination against tuberculosis applies:

• to children born to parents from countries where tuberculosis is common (the African and Asian continent, the countries of the Near and Middle East, the countries of Central and South America, the countries of Central and Eastern Europe, including Bulgaria, Estonia, Hungary, Latvia, Lithuania, Poland, Portugal and Romania);
• to the children themselves born in these countries;
• to children who owe stay more than a month in these countries ;
• children who have people with tuberculosis in their environment;
• to children living in Ile-de-France, Guyana or Mayotte, three regions in which the tuberculosis rate is higher than the national average;
• children for whom the doctor considers that there is a risk of tuberculosis, especially those who live in precarious conditions.

BCG from 1 month: at what age to vaccinate your infant?

It is recommended to vaccinate children at risk as soon as possible, from maternity. The tuberculin skin test, also called the tuberculin skin test (IDR), is only useful to check, before vaccination, that the person (child or adult) is not already infected with the Koch bacillus, which causes tuberculosis. This test can also be performed at any age, but is not necessary if the child is vaccinated before 3 months.

In practice, to limit the side effects associated with the BCG vaccine, the injection should always be done intradermally on the shoulder. The idea that the possible marks left by the vaccine would be less visible if it was done under the arm or in the thigh is not a sufficient argument because the risk of side effects is increased when the injection is given elsewhere than in the recommended site.

Tuberculosis: should a booster be given?

A single dose of vaccine is sufficient for the child, no need for a booster or control.

How much does the tuberculosis vaccination cost?

A medical prescription is essential to cover the costs of vaccination. The vaccine can then be bought in pharmacies and Social Security covers 65% of the price. Regarding vaccination, you can either turn to your doctor where the act will be paid for but reimbursed by Health Insurance, or to a public vaccination center, where the act will be free.

Fatigue, fever, reaction or even infection from the vaccine: how can I relieve my baby from side effects?

It is recommended to leave our child’s arm uncovered after the vaccination and to opt for clothes that do not tighten the area of ​​the bite. If a flow appears, we can apply a dry sterile compress, without any product on it. It is also possible to give your baby a pain reliever.

Tuberculosis in children: what are the consequences?

The BCG vaccine has above all a individual protection effect. It does not intervene in a significant way on the epidemiology of the disease, that is to say on the level of collective protection, unlike many other vaccines (DTP, rubella, measles, etc.).

As Professor Daniel Floret also points out, “ tuberculosis mainly affects adults. They are the ones who contaminate children through the air, the little ones do not contaminate each other. To avoid this, we focus on screening for the disease and its medical management. »

Tuberculosis causes:

• a high fever, often with night sweats
• acough chronic, sometimes with thick sputum or even streaks of blood
• shortness of breath
• of the chest pain
• very tired
• un emaciation linked to a consequent loss of appetite

Treatment is essentially based on combination of antibiotics prescribed over a long period, from 6 months to 2 years. Significant progress has been made not only in the detection of patients, but also in the monitoring of treatment.